软件工具及总代谢肿瘤体积计算的方法学因素对基线[18F]FDG PET预测霍奇金淋巴瘤生存情况的影响
Influence of Software Tool and Methodological Aspects of Total Metabolic Tumor Volume Calculation on Baseline [18F]FDG PET to Predict Survival in Hodgkin Lymphoma.
作者信息
Kanoun Salim, Tal Ilan, Berriolo-Riedinger Alina, Rossi Cédric, Riedinger Jean-Marc, Vrigneaud Jean-Marc, Legrand Louis, Humbert Olivier, Casasnovas Olivier, Brunotte François, Cochet Alexandre
机构信息
Department of Nuclear Medicine, Centre Georges-François Leclerc, Dijon, France; Le2i UMR CNRS 6306, Dijon, France; MRI Unit, Centre Hospitalier Régional Universitaire, Hôpital Le Bocage, Dijon, France.
Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America.
出版信息
PLoS One. 2015 Oct 16;10(10):e0140830. doi: 10.1371/journal.pone.0140830. eCollection 2015.
AIM
To investigate the respective influence of software tool and total metabolic tumor volume (TMTV0) calculation method on prognostic stratification of baseline 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography ([18F]FDG-PET) in newly diagnosed Hodgkin lymphoma (HL).
METHODS
59 patients with newly diagnosed HL were retrospectively included. [18F]FDG-PET was performed before any treatment. Four sets of TMTV0 were calculated with Beth Israel (BI) software: based on an absolute threshold selecting voxel with standardized uptake value (SUV) >2.5 (TMTV02.5), applying a per-lesion threshold of 41% of the SUV max (TMTV041) and using a per-patient adapted threshold based on SUV max of the liver (>125% and >140% of SUV max of the liver background; TMTV0125 and TMTV0140). TMTV041 was also determined with commercial software for comparison of software tools. ROC curves were used to determine the optimal threshold for each TMTV0 to predict treatment failure.
RESULTS
Median follow-up was 39 months. There was an excellent correlation between TMTV041 determined with BI and with the commercial software (r = 0.96, p<0.0001). The median TMTV0 value for TMTV041, TMTV02.5, TMTV0125 and TMTV0140 were respectively 160 (used as reference), 210 ([28;154] p = 0.005), 183 ([-4;114] p = 0.06) and 143 ml ([-58;64] p = 0.9). The respective optimal TMTV0 threshold and area under curve (AUC) for prediction of progression free survival (PFS) were respectively: 313 ml and 0.70, 432 ml and 0.68, 450 ml and 0.68, 330 ml and 0.68. There was no significant difference between ROC curves. High TMTV0 value was predictive of poor PFS in all methodologies: 4-years PFS was 83% vs 42% (p = 0.006) for TMTV02.5, 83% vs 41% (p = 0.003) for TMTV041, 85% vs 40% (p<0.001) for TMTV0125 and 83% vs 42% (p = 0.004) for TMTV0140.
CONCLUSION
In newly diagnosed HL, baseline metabolic tumor volume values were significantly influenced by the choice of the method used for determination of volume. However, no significant differences were found in term of prognosis.
目的
探讨软件工具和总代谢肿瘤体积（TMTV0）计算方法对新诊断霍奇金淋巴瘤（HL）患者基线2-脱氧-2-[18F]氟-D-葡萄糖正电子发射断层扫描（[18F]FDG-PET）预后分层的各自影响。
方法
回顾性纳入59例新诊断的HL患者。在任何治疗前进行[18F]FDG-PET检查。使用贝斯以色列女执事医疗中心（BI）软件计算四组TMTV0：基于绝对阈值选择标准化摄取值（SUV）>2.5的体素（TMTV02.5），应用每个病灶阈值为SUV最大值的41%（TMTV041），并使用基于肝脏SUV最大值的每个患者适应性阈值（>肝脏背景SUV最大值的125%和>140%；TMTV0125和TMTV0140）。TMTV041也使用商业软件确定，以比较软件工具。使用ROC曲线确定每个TMTV0预测治疗失败的最佳阈值。
结果
中位随访时间为39个月。用BI软件和商业软件确定的TMTV041之间存在极好的相关性（r = 0.96，p<0.0001）。TMTV041、TMTV02.5、TMTV0125和TMTV0140的中位TMTV0值分别为160（用作参考）、210（[28;154]，p = 0.005）、183（[-4;114]，p = 0.06）和143 ml（[-58;64]，p = 0.9）。预测无进展生存期（PFS）的各自最佳TMTV0阈值和曲线下面积（AUC）分别为：313 ml和0.70、432 ml和0.68、450 ml和0.68、330 ml和0.68。ROC曲线之间无显著差异。在所有方法中，高TMTV0值均提示PFS较差：TMTV02.5的4年PFS为83% vs 42%（p = 0.006），TMTV041为83% vs 41%（p = 0.003），TMTV0125为85% vs 40%（p<0.001），TMTV0140为83% vs 42%（p = 0.004）。
结论
在新诊断的HL中，基线代谢肿瘤体积值受体积测定方法选择的显著影响。然而，在预后方面未发现显著差异。
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